THR Navigating Recovery...the sequel

[ddj]

Day 22
Not sure why but last week has not been as comfortable. Most likely the result of increased walking and PT. I still need support to do the step up/step down movements, the “wall squats” (thighs horizontal to the floor) are a joke! I can only get down a little bit but do not intend to push beyond comfort! Besides I could not do that before surgery!!
Somebody should do PT videos with arthritic people over 65 demonstrating, not the young thin-bodied therapists with 0% body fat.....
Diet change/ supplements have helped some of the night time “restless” leg stuff——thank you
My return to work plan for next week went out the window...no possible opportunity for release until end of June. So I plan to work on refining my skill set in patience.....and finishing long over due sewing projects

 

[Jaycey]

I still need support to do the step up/step down movements, the “wall squats” (thighs horizontal to the floor) are a joke! I can only get down a little bit but do not intend to push beyond comfort! Besides I could not do that before surgery!!

At only days out of surgery why are you trying to do all this. You should be focusing on rest, ice and elevation - not trying to train. That hip has been traumatised. Please let it heal before trying any of this.

 

[ddj]

Week 4 completed
Spent the weekend moving around easily inside without a cane, outside with the cane. Minimal discomfort, strength increasing.
Very different story now. Sunday, during the night I got up for the middle of the night bathroom trip. Somehow slipped off the bed as I was getting up, twisted and fell onto my knees. After a bit I was able to get up by myself but last 48 hours have been painful, still able to walk and bear weight, but feels like I pulled or strained my muscles on my operative leg and jarred my hip joint.
Back to icing and elevating, minimal stretching exercises. MD office said to call back if I wasn’t “feeling better” after 2-3 days.
So much for a smooth recovery.....

 

[Layla]

Happy One Month Anniversary!

I’m so sorry to read about your fall. The experience must have been so frightening. Good to hear you’re resting and icing. I wish you comfort and hope you’re feeling better soon. Please keep us posted, we care.
@ddj

 

[ddj]

Thank you for your words. Frustrating to be so uncomfortable after feeling so good. Mad at my self for being so clumsy. My husband is now overflowing with anxiety every time I get up. Not good to talk about how I feel because he just gets more anxious.....

Old adage of “pride going before a fall” seems applicable...I was so involved with being able to move around so well and not needing much pain medication....now am back to needing it... I think I stressed muscles in my back and neck too.
My goal this week is to get an appointment with a friend who is a massage therapist.
Still have about 2 weeks before I have to return to work, so should still be ready by then

 

[Puggles]

Hello @ddj,

I am very new to posting on this forum, but have been reading for a few years.
Reading your recovery journey has been very educational ! I'm so sorry about
your fall, and hope your pain resolves!

I have a few questions------you said you were released to home in
FOUR HOURS?!?! That is amazing! Do you know how common that is?
I've read A LOT of post-op stories here, and have never seen a 4-hour
release yet, but maybe it's more common than I realize.

I'm also very curious about your fast release, because as far as I know,
they like you to be there at least overnight (at minimum), since needing
a blood transfusion is possible. Was there a specific reason that they
weren't concerned you might require a transfusion?

Also, did you receive
any injections of blood thinners before you left, and did they
help you put on compression hose before you left?

I have so much to learn, and I really appreciate your time! If I knew
I could possibly go home four hours after my THR, that would
take away SO many fears I have! I HATE
being in the hospital, and I already know that sleeping in their bed
is going to be nearly impossible! I only say that because I HAVE
to sleep in a recliner now---I absolutely can't sleep in any normal
beds anymore---believe me, I've tried.

The other HUGE reason I'd love to go home as quickly as you did is because I have incontinence, so I'm already worried about walking in the hallway with PT and leaking everywhere. As I said in my first OP, I have tried SO MANY kinds
of diapers, and they ALL leak, no matter what. Not only embarrassing at
the hospital, but dangerous for staff members to possibly slip on.

Ugh, I hope my questions aren't too much in one post! As you can
tell, I have SO. MANY. questions and concerns. Thank you, and hope
you keep getting better and better!

 

[ddj]

I am happy to share my experience. All questions are good and deserve attention. Information, planning, and preparing are the best ways to get ready.

Happy also to report that after 7days my pain levels are coming down and I am back to baseline. Ice, rest, elevate, pain meds, and gentle stretches finally resolved the fallout from the fall.

Yes I was home that quick. Went in at 6am for a 8am start time and I was home by 4:30. Surgery was done at an outpatient orthopedic surgery center. Did have general anesthesia but woke up fine, no nausea. Did have IV anti-nausea medication before I left the surgery suite. Anterior approach, and (I think) some internal pain medicine put into the tissue before the incision was closed.
There is a lot of screening done to be sure you are a good candidate for outpatient surgery and you have support people that will be with you 24/7. It is still major surgery, same as would be done in a hospital operating room.
Never had a conversation about needing a transfusion except to identify that I did not have religious objections to blood products. But if that is a concern than outpatient surgery would likely not be an option.

The other variable is the surgeon‘s preference and availability of an outpatient setting. So a lot depends on what is available in your area.

Of course insurance had to authorize and my expectation is the cost will not be much different than if I had a hospital surgery and stay.
A nurse visited me the next day and then PT + the nurse came on the second day after surgery.

I researched the outpatient option a lot and did have to advocate for myself (probably because of my age and type 2 diabetes).

For blood thinners he used aspirin and yes to the compression socks (thigh high). The non-operative leg had it on during surgery and operative leg as soon as the surgery finished. I was so happy to retire them at two weeks!!

As far as the leaking concerns, I found some nice absorbent washable underwear on Amazon, it is hard to get to the bathroom quickly with a walker or crutches. However, as a nurse I can assure you that we are used to “body fluids” of all types! Just goes with the territory

 

[ddj]

5 weeks (35 days) completed
Took about 5 days to recover from falling. Saturday we were able to take my Grandson on a special birthday trip to the Air and Space museum. (Airplanes, rockets, Mars rover etc)
With a couple rest stops on strategically placed chairs, walked around the museum for just over 3 hours. That and the 4 hr round trip drive made for a next day of recovery & rest!
Today I drove myself to pick up my granddaughter for a belated birthday gift. It is so nice that pedicures have taken first place in the birthday gift race.
Walking without the cane is doable, but I quickly start limping so plan is to use the cane to keep my gait right.

My “caregiver” (husband) asked me today when I was going back to work! I think I have worn out my welcome in the land of “can you help me….” Although I have resumed doing the household chores, outside work like weeding the garden and mowing the lawn I haven’t tried yet.

 

[Layla]

Hi @ddj
Thankfully you recovered from the fall.
Its nice to read your getting back to some normal activity, but also realizing when you need to rest. I understand this isn’t your first recovery and am not sure what you do for work, but five weeks seems rather ambitious to be considering a return soon, so hopefully hubs will be understanding. I’d hate to see you stall the nice recovery you’re enjoying. Following is an interesting article from the BoneSmart Library on healing, if you haven’t read it. It may be beneficial for family to read also as it gives us a better understanding on all that healing involves. I wish you all the best as you continue the journey.

Healing: how long does it take?

How Long Does it Take to Recover from Joint Replacement Surgery? Most patients undergoing total hip/knee replacement surgery want to know when they'll be able to return to their normal life. "Recovery time" is a common question posed to specialists and non-specialists alike. There are many...

bonesmart.org

 

[ddj]

Wow, that is what I appreciate so much from this forum, the depth of information plus the visuals that I can share with people around me.
I do still feel very fatigued very quickly. Haven’t even got out of bed this morning but I can feel the results of probably doing “too much walking” yesterday.
Spent the day with my granddaughter to make up for the birthday I missed right after my surgery. Exploring used bookstore (she is an avid reader and loves to read actual books) lunch, ice cream and manicures. After dinner a friend came over to take me on a walk…did not quite make 30 minutes but was close. So today’s agenda is ice, rest and more Tylenol for the achy soreness.
I guess, as a nurse, I make a terrible patient!

 

[Elf1]

@ddj sounds like you're doing good overall, happy to hear you're recovering from the fall. I think that is one of all new hippies nightmares.

Have to agree that going back to work so soon seems to be pushing it. And you've mentioned being a nurse so I can't imagine you get much time to sit, rest and ice. If it was an admin job you could at least sit, prop your leg up and even ice. Wishing you the best, you're doing great.

 

[ddj]

Fortunately mine is not an admin job. Am a home visiting nurse working with at risk women during pregnancy and through the first 2 years of their baby’s life. Lots of driving, developmental assessments, baby weights, mental health counseling and paperwork….
I have a standing desk so do not have to sit long stretches in the office.
In the end I guess it will be the surgeon’s call.
Reality right now is that I have no energy or endurance, still need at least one nap if not two!

 

[Layla]

Hello @ddj Happy Saturday!
Your job sounds interesting. I hope you able to enjoy more time off to build on your strength and energy. It can be a slow process back to normal energy levels. You may not feel better everyday, but I’ll bet you’re noticing some progress week to week.

Our body's energy supply isn't limitless. So when we're in healing mode after major surgery our energy will be used for healing first, not leaving a great reserve for all the other activity of daily life. It is completely normal to feel tired for quite some time. How long....most likely relates to your body's rate of healing. Making our best effort to get adequate sleep and rest is beneficial. Our body does it's best healing while we're sleeping.

Hopefully staying adequately hydrated, eating a balanced diet including protein and meting out activity will help get you back to where you want to be. I’ll include the article on Energy Drain from the Recovery Guidelines in case you haven’t had the time to read through all of the info yet.

Energy drain for THRs

Someone recently said something that gave me this idea to demonstrate what post-op hippies are always experiencing: we called it an energy drain also known as fatigue or acute tiredness. All perfect descriptions! And I thought of these illustrations demonstrating how much of your body's energy...

bonesmart.org

Have a lovely weekend!

 

[ddj]

Completed week 6, second post op visit and released to return to work next week.
My plan is to work hard not to work hard. Fortunately my supervisor is very focused on me “easing back in”. Going to be interesting to see how many emails are stacked up!
Ongoing discomfort:
Oddly I feel an increased deep ache in my upper thigh and incision. Most likely associated with increasing activity. Assuming ice and elevation is still needed.

This weekend I also ended up with a small topical staph infection which resolved by by appointment with antibacterial ointment. Probably irritated by clothing. Wondering if there is something to soothe the incision….Vit E cream?

Also wondering what is the best ratio of standing/sitting/driving for comfort. Last hip I was still doing inpatient nursing at the hospital so the job dictated my activity. This time I am in control.

 

[Layla]

Wow, a return to work at this point is pretty ambitious. I do hope your supervisor makes good on the promise to let you ease back in.

I think it would be wise for you to ice, elevate and rest while you’re experiencing the deep ache in your thigh and incision area. I’m assuming a physician diagnosed your infection and advised treatment?

You really should not apply anything close to or on the stitches or incision without the approval of your surgeon. It normally takes four to six weeks for the incision to fully heal and close. You don't want to risk infection by applying a product near an open area before that time. Some of the more common creams and lotions used on a fully healed incision are Bio-Oil, Vitamin E Oil, E45 Cream, Palmer's Cocoa Butter Lotion with Vitamin E, and Coconut Oil.

The one exception to this guidance is a product called ACTIVE Skin Repair Hydrogel. This gel contains hypochlorous (HOCL), a compound made naturally by your body to promote healing. It can be applied to your incision at any point during recovery - it's a germ fighter as well as a healing and moisturizing agent. But you still should discuss its use with your surgeon before using it.

Also in regard to your question about balancing activity with rest, go slow. If you do too much, you will feel it as you are now. Rest when you’re tired and ice and elevate when you’re feeling discomfort or pain. As far as driving, in the early months I couldn’t tolerate being confined in one position in the car for more than 30-40 minutes. We are all different in that respect though and what bothers one, may not bother another. If you‘re talking about a road trip, I‘d certainly advise you take regular breaks.

Have a great rest of the week!
@ddj

 

[ddj]

7 weeks completed….tomorrow (June 28th) is return to work day.

Incision healing with a small area of the skin that opened up where the infection was. I think the initial irritation came from my underpants rubbing. Took my scissors and made a small cut on the leg opening so nothing is rubbing. Of course once area is fully healed I get to go shopping for new underwear!

I actually have some hydrogel pads, thank you for the idea. Should have thought of that….surprising how your critical thinking skills evaporate after surgery…or maybe it is all the Netflix I have been watching!

Yesterday I was able to navigate open, uneven ground! (with the cane). Went to my older granddaughter’s wedding. Beautiful 1 1/2 hr drive (with two stops) winding through the western Oregon mountains. Was able to cross an open hay field (already harvested) to the area where the ceremony was held, next to a small mountain stream. But only did the walk one way. Sent my hubby for the car after sitting in metal chairs for the 45 minute ceremony.
Today (Sunday) will definitely be rest day.

 

[djklaugh]

@ddj The wedding trip sounds lovely! Such a blessing that you were able to see your granddaughter get married! Hope you are staying cool today -- it's going to be a scorcher here in Oregon!

 

[Layla]

Happy One Month Anniversary! I hope you continue to enjoy steady progress.

The setting for your granddaughters wedding sounds beautiful.

Hopefully you’re adjusting well with your return to work. Let us know how it’s going as time allows. Until then…all the best!
@ddj

 

[ddj]

Post surgery: 3 months!
Return to work at 7 weeks was a bit stressful…fatigued very quickly. Hard to concentrate at times.
Have been dancing twice, it is so nice to be able to dance again. I do still have to modify some of the steps, especially the turning on my right foot ones. This new hip still has some aches and pains. And some of the movements it is just not ready to do.
I think I am still building endurance and strength.

 

[ddj]

Post surgery 5 months. Walking, moving and dancing without much pain, a fading scar the only constant reminder.
Tomorrow we are off to explore a remote tributary of the Amazon river. Fly into the area in a small plane and land on the river. Jungle living at the basic level. Carrying in the supplies. No phones, no electricity. Sleeping in tents, Catching our dinner. Cooking on the fire. Yes we do have a guide. Fishing a river that has seen very few humans.

It is amazing that the trip that became the focus to keep me moving through the first weeks of pain is really happening. I appreciate this forum and the support, it really has had a positive impact on my recovery this time. Thank you